Intraoperative outcomes and safety of femtosecond laser-assisted cataract surgery: Canadian perspective

Abstract

ObjectiveTo report the intraoperative surgical outcomes and safety of femtosecond laser–assisted cataract surgery (FLACS) during surgeon learning curve and compare those outcomes with those of conventional phacoemulsification in a Canadian public hospital setting. DesignRetrospective chart review. ParticipantsFLACS and phacoemulsification patients at Brandon Regional Health Centre, Brandon, Manitoba, Canada. MethodsIntraoperative surgical outcomes and safety (rates of intraoperative complications and phacoemulsification parameters) were compared among 3 groups: the first consecutive 197 cases using femtosecond laser (FSL) pretreatment to ultrasound phacoemulsification in cataract surgery (group 1; early FLACS), the second consecutive 165 cases using FSL (group 2; later FLACS), and 80 consecutive conventional cataract surgery cases (group 3; conventional phaco). ResultsThere was a statistically significant difference for phacoemulsification parameters (actual phaco time [APT], effective phaco time [EPT], and ultrasound average) among the 3 groups (all p-values < 0.05). The mean phacoemulsification parameters (APT and EPT) for the early FLACS and the conventional phaco groups were significantly longer than those for the later FLACS group (p < 0.05). The mean FSL time for the early FLACS group was significantly longer than that for the later FLACS group. There was no statistical difference among the rates of intraoperative complications (suction breaks, capsular tags, FSL-induced miosis, posterior capsular tears, and anterior vitrectomy) for the 3 groups. ConclusionsDuring the learning curve, the intraoperative outcomes and safety of FLACS are comparable to the conventional phacoemulsification technique. After the learning curve, FLACS is significantly superior to conventional surgery in all measured phacoemulsification parameters.